A 34-year-old man presented with acute severe left-sided abdominal and flank pain with associated postprandial nausea and vomiting. CT imaging revealed findings suspicious for a closed loop small bowel obstruction. Intraoperative findings were that of a left paraduodenal hernia (of Landzert) secondary to a mesenteric defect immediately posterior to the ascending branch of the left colic artery. The defect was closed via minilaparotomy. Unfortunately, his postoperative course was complicated by small bowel obstruction which required further laparotomy and adhesiolysis. The patient eventually made a good recovery. Here, we present a rare case of intestinal obstruction and discuss the aetiologies and management of this unusual phenomenon.
- gastrointestinal surgery
- general surgery
Statistics from Altmetric.com
Contributors All authors were involved in either or both of: (1) the direct clinical care of the patient. (2) The writing or editing of the contents of this manuscript. YMC: involved in direct clinical care and operative management of patient; literature review; write up of case report; image editing; follow up of patient postdischarge. GA: literature review; editing of literature review, case report and references, write up of abstract; follow up of patient postdischarge; assistance with BMJ Case report specific formatting. MATA: involved in direct clinical care and operative management of patient; obtained laparoscopic and CT images for figures; supervisory role for the authorship of this case report. SM: involved in direct clinical care and operative management of patient; supervising consultant surgeon for the care of patient; supervisory role for the authorship of this case report.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.